Levels Of Anemia149 Hemoglobinlessthan11149 Hemoglobinlesthan9Moderate149 Hemoglobinlessthan7Severe Hypoxia149 LowPO2149 OxygenContentHemoglobinPO2149 Acutesignssymptoms149 ID: 945245
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THE ANEMIASInadequate ConstructionVsExcessive Destruction Levels Of A
nemia• Hemoglobinlessthan11• Hemoglobinlesthan9:Moderate
49; Hemoglobinlessthan7:Severe Hypoxia• LowPO2• OxygenConte
nt=Hemoglobin+PO2• Acutesigns/symptoms:• Chronicsigns/sympt
oms: Cyanosis• FivegramsofhemoglobinareFULLY desaturated Two way
s to approach Anemia… (1) Check RETICULOCYTE COUNT ANEMICLow RET
ICULOCYTE count• Hypoproliferative• (1)SomethingisMISSING f
romthebonemarrowor…• (2)Bonemarrowis suppressedHigh RETICUL
OCYTE • Hyperproliferative• HemolyticAnemia– Intravasc
ular– Extravascular Vasculitis in progress Extravascular Hemolys
is• Mcc: Autoimmune hemolysis: Do coombs test Drugs that cause
extravascular Hemolysis• Penicillins• Cephalosporins•
Sulpha• Dapsone• AlphaMethylDopa• PTU• HIPPPE Par
oxysmal Nocturnal Hemoglobinuria• First described in military re
cruits• RBCs are sensitive to hemolysis by acidosis• HAMS t
est Hereditary Spherocytosis• Autosomal Dominant• SPECTRIN
defect• Osmotic fragility test Hereditary Elliptocytosis• A
utosomal Dominant Some RBCs can talk… …Here is what they ha
ve to say Reticulocyte Spherocyte Elliptocyte Schistocyte Tear Drop C
ell Target Cell Heinz Body Basophilic Stippling Acanthocytes Anisocyt
osis Poikylocytosis The second way to approach Anemia• Check a C
BC with differential• MCV• MCH• MCHC Microcytic Hypoch
romic• Low MCV• Low MCH• Impaired hemoglobin PRODUCTIO
N Microcytic Hypochromic Anemias• Iron Deficiency• Chronic
Disease, late• Lead poisoning• Thallessemias• Hemoglob
inopathies• Sideroblastic anemia Microcytic Hyperchromic• L
ow MCV• High MCHC ( MCH/MCV)• The cells are too small Micro
cytic Hyperchromic Anemias• Hereditary Spherocytosis Normocytic
Normochromic• Normal MCV• Normal MCH• NOTHING is wrong
with the RBCs…• You do not have enough of them Normocytic
Normochromic Anemias• Acute Hemorrhage (less Than 4 days)•
Chronic disease, early• Renal failure• Hypothyroidism, earl
y Macrocytic Anemia• High MCV• Impaired nuclear division Ma
crocytic Anemias• B12 Deficiency• Folate Deficiency• H
ypothyroidism, severe• Reticulocytosis• Alcohol• Chemo
therapy drugs• Anticonvulsants Anticonvulsants• Phenytoin&#
149; Ethusuximide• Valproic Acid• Carbamezapine Organizatio